Coffee & Coverage: Does Medicare Cover Knee Braces?

knee brace, medicare coverage
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This article was updated on April 8, 2021.

Medicare Part B covers knee braces as long as they are deemed medically necessary. Knee braces are considered durable medical equipment, or DME. Durable medical equipment is medical equipment that can go through repeated use and last at least three years.

What are the costs?

You will pay 20 percent of the Medicare-approved amount of the knee brace, while Medicare pays 80 percent. The Part B deductible applies. 

According to medicare.gov, the specific amount you’ll pay depends on different factors, such as other insurance you may have, how much your doctor charges, and the type of medical facility you visit.

Why a knee brace?

A knee brace is a tool used to manage the discomfort of knee osteoarthritis. A brace reduces pain by shifting your weight off the most damaged portion of your knee. Wearing a brace can improve your ability to get around, alleviate pain, and help you walk farther comfortably.

Wearing a knee brace can help to delay having to undergo knee replacement surgery later on.

Osteoarthritis

Osteoarthritis is a complex condition involving the entire joint. It is considered the wear-and-tear type of arthritis that commonly affects the knees of older people. It commonly affects one side of your knee more than the other. This unequal damage can cause your knee to align imperfectly. This is called malalignment, which can make you look knock-kneed or bow-legged.

As the damage increases, malalignment advances. A knee brace can take pressure off the part of your joint that is most affected by osteoarthritis, relieving pain. If your knee feels like it might buckle when you put weight on it, a knee brace can also help provide more stability and allow you to move freely with more confidence.

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What kind of knee brace?

Your doctor may refer you to an orthotist, who can fit a custom knee brace to you. Alternatively, you can purchase a standard brace from a drug store as prescribed by your doctor.

The only requirements are that the brace be rigid or semi-rigid. The brace should be able to take pressure off the damaged part of the joint that is causing pain and difficulty of movement.   

Risks

Risks of wearing a knee brace might include:

  • Discomfort. A knee brace can feel heavy, bulky, and hot at first. A poor fit can cause it to slip.
  • Skin irritation or swelling. The skin under the brace might become red and irritated if your knee brace fits poorly. Some people also have swelling around the joint.
  • Stiffness. Wearing a brace can cause the wearer to treat the braced knee as injured and favor the other knee, which could contribute to joint stiffness.
  • No results. Studies of knee braces for people with osteoarthritis have been limited, and results have been mixed. Some people see no benefit. Others report diminished pain and increased function.

Beware of fraud and scams

Unfortunately, knee braces are fraught with scams. Beware of anyone calling you about a free knee brace. These widespread scams take thousands of dollars from Medicare for products that are cheap and not well made.

If you need a knee brace, go through your doctor to get one. Do not give out your personal information to anyone you don’t know.

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